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October 11, 2024

OMB Communications with Congress Regarding 2017 ACA Repeal Efforts

Records received from the Office of Management and Budget in response to American Oversight’s request for communications and notes reflecting any meetings between OMB staff and members of Congress in spring 2017, as House Republicans, with the support of President Trump, attempted to repeal and replace the Affordable Care Act (ACA). 

Records received from the Office of Management and Budget in response to American Oversight’s request for communications and notes reflecting any meetings between OMB staff and members of Congress in spring 2017, as House Republicans, with the support of President Trump, attempted to repeal and replace the Affordable Care Act (ACA). 

The records show that HHS and OMB staff members frequently communicated with certain congressional officials and members — including then-Speaker of the House Paul Ryan and members of his office — in early 2017 while ACA repeal efforts were underway.

On March 6, 2017, the day House Republicans announced their plan to replace the ACA with the American Health Care Act (AHCA), Ryan’s policy director Austin Smythe asked then-OMB Director Mick Mulvaney to produce an analysis contradicting information expected to be released by the Congressional Budget Office, the emails show.

“It will help us make the case for the bill if we got information from OMB/HHS to show the full effects of our bill combined with administrative action,” Smythe wrote.

Mulvaney responded the same day: “Austin..help me. What are you specifically asking us to do?”

“After CBO puts out their cost estimate (likely a week from today), produce an analysis that states they’ve under-estimated coverage numbers and premium decreases because they haven’t taken into account administrative actions by HHS and you,” Smythe wrote.

“Understood.. Thanks,” Mulvaney responded.

On March 9, Mulvaney asked Smythe if he could include OMB’s Deputy Associate Director for Health Tom Reilly in the conversation. In an email three days later, Smythe included Reilly along with Russ Vought and Joe Grogan, who were both OMB officials at the time and later contributed to Project 2025.

On March 13, Mulvaney emailed Smythe details about a conversation he had with Ryan regarding efforts to pass the AHCA. Ryan was also included on the email. 

“Paul you seem to believe the proposed resolution language that Austin sent out would be flexible enough to cover both the flexible block grants and this expansion issue,” Mulvaney wrote. 

Ryan responded with several emojis and the word “Yup.”